A noninvasive urinary microRNA-based assay for the detection of pancreatic cancer from early to late stages: a case control study.

Background: Pancreatic cancer is highly aggressive and has a low survival rate primarily due to late-stage diagnosis and the lack of effective early detection methods. We introduce here a novel, noninvasive urinary extracellular vesicle miRNA-based assay for the detection of pancreatic cancer from early to late stages.

Methods: From September 2019 to July 2023, Urine samples were collected from patients with pancreatic cancer (n = 153) from five distinct sites (Hokuto Hospital, Kawasaki Medical School Hospital, National Cancer Center Hospital, Kagoshima University Hospital, and Kumagaya General Hospital) and non-cancer participants (n = 309) from two separate sites (Hokuto Hospital and Omiya City Clinic).

An artificial intelligence-based nerve recognition model is useful as surgical support technology and as an educational tool in laparoscopic and robot-assisted rectal cancer surgery.

Background: Artificial intelligence (AI) has the potential to enhance surgical practice by predicting anatomical structures within the surgical field, thereby supporting surgeons' experiences and cognitive skills. Preserving and utilising nerves as critical guiding structures is paramount in rectal cancer surgery. Hence, we developed a deep learning model based on U-Net to automatically segment nerves.

Mini-Laparotomy for Superior Mesenteric Artery Aneurysm Due to Takayasu's Arteritis.

Superior mesenteric artery aneurysm (SMAA) is reported to be the third-most common type of visceral aneurysm (VA), accounting for 5% of all VAs. The etiology of SMAA is commonly thought to be infection, and it usually exists in the proximal part of the superior mesenteric artery, which is suitable for endovascular treatment. We herein report an extremely rare case of the distal part of SMAA caused by Takayasu's arteritis (TA), which was successfully resected using a mini-laparotomy method without impairing the intestinal blood supply.

Intraductal papillary neoplasm of the bile duct developing in a patient with primary sclerosing cholangitis: a case report.

We report a case of intraductal papillary neoplasm of the bile duct (IPNB) that developed in a patient with primary sclerosing cholangitis. A 46-year-old woman was admitted to our hospital with obstructive jaundice. The liver function tests demonstrated increased serum liver enzyme levels.

Aspartate aminotransferase-to-platelet ratio index is associated with liver cirrhosis in patients undergoing surgery for hepatocellular carcinoma.

Background: Among various preoperative evaluations of liver function, accurate assessment of liver cirrhosis (LC) is especially important in patients undergoing surgery for hepatocellular carcinoma (HCC).

Objective: To explore the most significant laboratory parameter associated with LC in patients undergoing surgery for HCC.

Methods: From among 588 HCC patients in our collected database who underwent liver surgery, 371 for whom sufficient laboratory data were evaluable, including direct serum fibrosis markers such as hyaluronic acid and type 3 procollagen peptide (P-3-P), were enrolled.

Inflammation-based prognostic score predicts biliary stent patency in patients with unresectable malignant biliary obstruction.

Background: An inflammation-based prognostic score, the modified Glasgow prognostic score (mGPS), has been reported to be useful for predicting postoperative survival in patients with various types of cancer. However, no studies have investigated whether the mGPS can predict biliary stent (BS) patency in patients undergoing BS placement for unresectable malignant biliary obstruction (UMBO).

Aim: To evaluate the usefulness of the mGPS for predicting BS patency in patients undergoing intraoperative placement of uncovered expandable metallic stents (EMSs) for UMBO.

Usefulness of a new inflammation-based scoring system for prognostication of patients with hepatocellular carcinoma after hepatectomy.

Background: We investigated whether a preoperative scoring system (the "CRP-AFP Score [CAS]") based on the serum levels of C-reactive protein and alpha-fetoprotein would predict outcome in patients undergoing hepatectomy for hepatocellular carcinoma.

Methods: The CAS was defined as follows: patients with an elevated level of both C-reactive protein (>.3 mg/dL) and alpha-fetoprotein (>20 ng/mL) were assigned a score of 2, and patients showing one or none of these abnormalities were assigned a score of 1 or 0, respectively.

Results of pancreaticoduodenectomy with portal or superior mesenteric vein resection for locally advanced pancreatic head cancer.

Background/aims: It is known that portal vein (PV) or superior mesenteric vein (SMV) is easily invaded by locally advanced pancreatic head cancer due to anatomical characteristics. Few studies have investigated the results of PD with PV or SMV resection (PVR) for pancreatic head cancer.

Methodology: We retrospectively reviewed a database of 83 patients who had undergone PD for pancreatic head cancer (PC).

Outcome of hepatectomy for hepatocellular carcinoma in elderly patients with portal hypertension.

The outcome of liver resection (LR) for elderly hepatocellular carcinoma (HCC) patients with portal hypertension (PHT) who may be excluded as liver transplantation candidates has not been fully evaluated. One hundred ninety-five patients who underwent initial curative LR for HCC with PHT were divided into 2 groups: age <70 years (n = 131) and age ≥70 years (n = 64). Clinicopathologic data and postoperative complications were compared.

When hepatic-side ductal margin is positive in N+ cases, additional resection of the bile duct is not necessary to render the negative hepatic-side ductal margin during surgery for extrahepatic distal bile duct carcinoma.

Background: The current standard treatment for extrahepatic distal bile duct carcinoma (EDBDC) is surgical resection, as no effective alternative treatment exists. In this study, we investigated the treatment strategies and outcomes for 90 cases of EDBDC at our department.

Material And Methods: Between April 2000 and March 2013, 90 pancreatoduodenectomies (PDs) were performed for EDBDC.

Discrepancy of B cell frequency between periphery and spleen after rituximab treatment in ABO-incompatible liver transplantation.

ABO-incompatible living-donor liver transplantation (ABO-LDLT) is generally more difficult to perform than ABO-incompatible kidney transplantation. Despite introduction of rituximab, ABO-LDLT in non-responders is a still difficult issue. A 23-year-old woman with primary sclerosing cholangitis underwent LDLT.

Usefulness of an inflammation-based prognostic score (mGPS) for predicting survival in patients with unresectable malignant biliary obstruction.

Background: An inflammation-based prognostic score, the modified Glasgow Prognostic Score (mGPS), has been established as a useful tool for predicting postoperative outcome in patients with cancer. However, no studies have investigated the usefulness of the mGPS for prognostication in patients undergoing palliative surgery for unresectable malignant biliary obstruction (UMBO). The present study was conducted to investigate whether the mGPS is useful for predicting the postoperative survival of patients undergoing intraoperative placement of an expandable metal stent for UMBO, or not.

Patient with adult-onset type II citrullinemia beginning 2 years after operation for duodenal malignant somatostatinoma: Indication for liver transplantation.

We report a 51-year-old female patient with adult-onset type II citrullinemia (CTLN2) who had a history of pancreatoduodenectomy for duodenal somatostatinoma with metastases to regional lymph nodes at age 49 years, paying special attention to indications for liver transplantation. At age 50 years, she developed hepatic encephalopathy with elevation of plasma ammonia and citrulline levels. A diagnosis of CTLN2 was made by DNA analysis of the SLC25A13 gene and treatment with conservative therapies was begun, including a low-carbohydrate diet and supplementation with arginine and sodium pyruvate.

Effect of billroth II or Roux-en-Y reconstruction for the gastrojejunostomy on delayed gastric emptying after pancreaticoduodenectomy: a randomized controlled study.

Objective: Delayed gastric emptying (DGE) is one of the major complications after pancreaticoduodenectomy (PD), occurring in 14% to 61% of cases. There have been no studies that compare the incidence of DGE in terms of the reconstruction method of gastrojejunostomy performed in subtotal stomach-preserving pancreaticoduodenectomy (SSPPD). The objective of this study was to evaluate the superiority of Billroth II (B-II) to Roux-en Y (R-Y) reconstruction on decreasing the incidence of delayed gastric emptying DGE after SSPPD by a prospective randomized controlled trial.

Survival after surgery for hepatocellular carcinoma in relation to presence or absence of viral infection.

Background: The aim of this study was to compare postoperative survival between hepatocellular carcinoma (HCC) patients with and without viral infection.

Methods: From among 398 HCC patients in our collected database, 377 who underwent surgery were enrolled. The patients were divided into 2 groups: group 1, those who had no hepatitis B virus or hepatitis C virus infection, and group 2, those who had hepatitis B virus or hepatitis C virus infection.

Effect of menatetrenone, a vitamin k2 analog, on recurrence of hepatocellular carcinoma after surgical resection: a prospective randomized controlled trial.

The aim of this study was to investigate whether menatetrenone (MNT) suppresses hepatocellular carcinoma (HCC) recurrence in patients undergoing hepatectomy. Between January 2005 and September 2009, 101 patients who underwent curative hepatectomy for primary HCC were enrolled in the study. Patients were divided into two groups: a non-MNT group (n=51), and an MNT group (n=50) that was administered 45 mg of MNT daily.

Single-stage intraoperative transhepatic biliary stenting in patients with unresectable hepatobiliary pancreatic tumors.

Background: The current study was conducted to evaluate the safety and utility of intraoperative transhepatic biliary stenting (ITBS) in patients with unresectable malignant biliary obstruction (UMBO) diagnosed intraoperatively.

Methods: In this study, 50 patients who underwent ITBS for UMBO between April 2001 and May 2009 were retrospectively reviewed. For 26 patients who underwent preoperative percutaneous transhepatic biliary drainage (PTBD), the expandable metallic stent (EMS) was inserted intraoperatively by the PTBD route in a single stage.

Body mass index is a risk factor of pancreatic fistula after pancreaticoduodenectomy.

Pancreatic fistula (PF) after pancreaticoduodenectomy (PD) is still a severe complication and a challenging problem. The common risk factors are the soft pancreas and small pancreatic duct of the remnant pancreas. Those two risk factors were recognized during surgery.

Surgical inflammation induces hepcidin production after abdominal surgery.

Background: Hepcidin, a key regulator of iron homeostasis, is also a marker of acute inflammation. In the present study we investigated the changes in the serum hepcidin level and correlations between hepcidin and other markers of acute inflammation during the perioperative period in patients after abdominal surgery.

Methods: Serum hepcidin, hemoglobin (Hb), hematocrit (Ht), white blood cell (WBC) count, frequency of neutrophils, and C-reactive protein (CRP) were measured preoperatively (Pre), and on postoperative days (POD) 1, 3, 7, and 14.

Intraoperative observation using a fluorescence imaging instrument during hepatic resection for liver metastasis from colorectal cancer.

Background/aims: We have found that liver metastasis from colorectal cancer (LM-CRC) can be easily detected by its fluorescence using a fluorescence imaging instrument (photodynamic eye (PDE)) in patients who have received an intravenous injection of indocyanine green (ICG). Therefore, our aim is to demonstrate the usefulness of PDE observation for hepatic resection in patients with LM-CRC.

Methodology: Between February and October 2009, seven patients who underwent hepatic resection for LM-CRC were enrolled.

Primary hepatic leiomyosarcoma: Case report and literature review.

Primary hepatic leiomyosarcoma are rare tumors with less than 30 cases reported in the English literature. Non specific presentations and often diagnosis delayed until they reach a large size, is the norm with therapy leading to an often dismal prognosis. A 67-year-old man presented complaining of abdominal pain and a palpable abdominal mass since Jan 2010.

Laparoscopic resection of epidermoid cyst arising from an intrapancreatic accessory spleen: a case report with a review of the literature.

We describe a rare case of epidermoid cyst arising in an intrapancreatic accessory spleen that presented as a cystic mass in the tail of the pancreas, and for which laparoscopic distal pancreatectomy was performed successfully. A 36-year-old woman with a cystic mass in the tail of the pancreas, which had been discovered incidentally at a medical checkup, was referred to our department for further examination. Endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography and positron emission tomography demonstrated a multilocular cyst in the tail of the pancreas without any evidence of malignancy, although differential diagnosis was extremely difficult because of the neoplasm-like appearance of the lesion.

Impact of grading of liver metastasis on postoperative outcome in patients with liver metastases from colorectal cancer.

Background/aims: Few studies have investigated grading of liver metastasis (GLM) in patients with liver metastases from colorectal cancer (LM-CRC).

Methodology: To screen for the most useful predictive factors in patients undergoing hepatic resection for LM-CRC, clinico-pathological factors were subjected to uni- and multivariate analyses.

Results: One hundred and twenty-five patients were evaluated retrospectively.

Underweight patients show an increased rate of postoperative death after surgery for hepatocellular carcinoma.

Objective: To evaluate the influence of body mass index (BMI) on postoperative death in patients undergoing surgery for HCC.

Methods: Three hundred forty-two patients were enrolled, and divided into three groups: Group A, BMI <22.5; Group B, BMI ≥22.